Grade 3/4 neutropenia is a limiting factor in second-line FOLFIRI following FOLFOX4 failure in elderly patients with metastatic colorectal cancer

  • Authors:
    • Yasutoshi Kuboki
    • Nobuyuki Mizunuma
    • Masato Ozaka
    • Mariko  Ogura
    • Mitsukuni Suenaga
    • Eiji Shinozaki
    • Satoshi Matsusaka
    • Keishou  Chin
    • Masaaki Matsuura
    • Kiyohiko Hatake
  • View Affiliations

  • Published online on: February 28, 2011     https://doi.org/10.3892/ol.2011.260
  • Pages: 493-498
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Abstract

Previous studies have reported improved outcomes for elderly patients with metastatic colorectal cancer (mCRC) treated with oxaliplatin or irinotecan as first-line chemotherapy. However, few studies regarding second-line chemotherapy with oxaliplatin or irinotecan are currenlty available. We analyzed retrospectively the efficacy and toxicity in elderly patients (median age, 74 years) treated with second-line FOLFIRI following first-line FOLFOX4 failure. From March 2005 to January 2008, 35 elderly patients with mCRC received first-line FOLFOX4 comprising leucovorin, 5-FU and oxaliplatin followed by second-line FOLFIRI comprising leucovorin, 5-FU and irinotecan. The median number of treatment courses with FOLFIRI was 5 (range 2-32). One patient responded to the treatment. The disease control rate was 38.2%. The median time to treatment failure was 3 months, and the median overall survival (OS) time from the beginning of first-line chemotherapy was 20.7 months. The incidence of grade 3/4 neutropenia was 71.4%, while febrile neutropenia was 11.4%. The incidence of non-hematological toxicity was low. The use of the three active drugs, 5-FU, oxaliplatin and irinotecan, in mCRC produced the longest OS in elderly as well as in younger patients. However, the elderly patients treated with second-line FOLFIRI had a high rate of hematological toxicity. Second-line FOLFIRI may therefore be used with caution in the elderly.
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May-June 2011
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Spandidos Publications style
Kuboki Y, Mizunuma N, Ozaka M, Ogura M, Suenaga M, Shinozaki E, Matsusaka S, Chin K, Matsuura M, Hatake K, Hatake K, et al: Grade 3/4 neutropenia is a limiting factor in second-line FOLFIRI following FOLFOX4 failure in elderly patients with metastatic colorectal cancer. Oncol Lett 2: 493-498, 2011.
APA
Kuboki, Y., Mizunuma, N., Ozaka, M., Ogura, M., Suenaga, M., Shinozaki, E. ... Hatake, K. (2011). Grade 3/4 neutropenia is a limiting factor in second-line FOLFIRI following FOLFOX4 failure in elderly patients with metastatic colorectal cancer. Oncology Letters, 2, 493-498. https://doi.org/10.3892/ol.2011.260
MLA
Kuboki, Y., Mizunuma, N., Ozaka, M., Ogura, M., Suenaga, M., Shinozaki, E., Matsusaka, S., Chin, K., Matsuura, M., Hatake, K."Grade 3/4 neutropenia is a limiting factor in second-line FOLFIRI following FOLFOX4 failure in elderly patients with metastatic colorectal cancer". Oncology Letters 2.3 (2011): 493-498.
Chicago
Kuboki, Y., Mizunuma, N., Ozaka, M., Ogura, M., Suenaga, M., Shinozaki, E., Matsusaka, S., Chin, K., Matsuura, M., Hatake, K."Grade 3/4 neutropenia is a limiting factor in second-line FOLFIRI following FOLFOX4 failure in elderly patients with metastatic colorectal cancer". Oncology Letters 2, no. 3 (2011): 493-498. https://doi.org/10.3892/ol.2011.260